Title Page

  • Conducted on

  • Prepared by

  • Location

Details

  • Location
  • Contractor:

  • Person in charge of the site:

  • BRS Staff on-site:

  • Job Ref:

  • Inspected By:

  • Date/Time:

PERSONNEL ON SITE:

  • Is the correct PPE being used where required by task? <br>(i.e. hard hat, safety vest, safety boots, gloves, ear plugs/muffs, dust mask, safety glasses, long-long compliance, respirator, face guards, guards evident on machines)

GENERAL SITE:

  • Are hazards identified, recorded, and addressed on the Job Start?

  • Have all staff & visitors signed the Job Start?

  • Are work instructions on site for work being undertaken?

  • Have all underground services been located?

  • Are current Utility Plans on site?

  • Is the Excavation Permit accurate, complete, current and on site?

  • Are all property agreements and conditions current and onsite?

  • Have plant checks on the Drill Rig and Excavators been done in the last week?

  • Is the Drill Rig earthed correctly?

  • If working at height, are all height safety requirements being met?

  • Is the work site clean and free of clutter?

  • Are tools and equipment being stored safely?

  • Is waste material (rubbish) taken away and stored correctly?

  • Has MBIE (OSH) been notified if the trench is >1.5m deep?

  • Are all fuels and chemicals safely and securely stored?

  • Are the Material Safety Data Sheets on site for all fuels and chemicals?

ENVIRONMENTAL WORK PRACTICES

  • If working near trees, are the correct procedures being followed?

  • Is damage to grass areas and vegetation being minimised?

  • Are any leaks, spills or discharges from the Site being controlled?

  • Have the sediment & erosion control measures been installed in accordance with erosion and sediment control guidelines?

PLANT/EQUIPMENT:

  • Are all WOF/COF/Rego/RUC current?

  • Do all Driver/Operators of plant have the correct Licences & endorsements?

  • Is tie down equipment secure & in good condition?

  • Are Mobile Plant Operators wearing seat belts?

PUBLIC SAFETY:

  • Are Barriers and Fences being used correctly? <br>(e.g. All open holes fully fenced as per guidelines)

  • Are all Barriers and Fences in good condition?<br>(e.g. all mesh secure, no holes)

  • Is the Drill fully fenced with a 1m clearance?

  • Are temporary walkways/paths in place for pedestrians and cyclists?

TRAFFIC CONTROL

  • Is a TMP required and in place?

  • Has the site been set out in accordance with authorised TMP?

  • Are the approved TMP drawings onsite?

  • Is there an accredited STMS responsible for the site?

  • Has a traffic control checklist/audit been completed and recorded on the Job Start?

  • Is there an escape route for the Traffic Controller?

EMERGENCY EQUIPMENT:

  • Is there a suitable 1st Aid Kit present on site?

  • Are Fire Extinguishers present and easily accessible?

  • Is the site able to call for emergency assistance – Fire, Police, Ambulance?

  • Is there a suitable Spill Kit on site?

ELECTRICAL EQUIPMENT:

  • Have all electrical tools and leads been checked and tagged in the last 6 months?

  • Is RCD protection being used where required?

OTHER:

  • OTHER:

  • Corrective Actions:

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